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Surg Radiol Anat (2006) 28:646649 DOI 10.1007/s00276-006-0147-3
ANATOMIC VARIATIONS
Accessory cardiac bronchus and tracheal bronchus anomalies: CT-bronchoscopy and CT-bronchography Wndings
Harun Yildiz Sahin Ugurel Kenan Soylu Mustafa Tasar Ibrahim Somuncu
Received: 5 August 2005 / Accepted: 4 August 2006 / Published online: 23 November 2006 Springer-Verlag 2006
Abstract Most common developmental anomalies of bronchial tree include accessory cardiac bronchus (ACB) and tracheal bronchus (TB). Minor bronchial anomalies include variants of TB, displaced segmental bronchi, and bronchial agenesis. We present CT-bronchoscopy and CT-bronchography Wndings of three cases with either ACB or TB. Recognition of these anomalies is important, as associated clinical complications, including recurrent episodes of infection, hemoptysis, and perhaps malignancies may be anticipated in a small percentage of patients.
Keywords Accessory cardiac bronchus
Tracheal bronchus Virtual bronchoscopy Bronchus Computer tomography
Introduction
Most common developmental anomalies of bronchial tree include accessory cardiac bronchus (ACB) and tracheal bronchus (TB) [3, 4]. An ACB is a supernumerary bronchus from the inner wall of the right main bronchus or intermediate bronchus that advances
toward the pericardium [3]. The term TB encompasses a variety of bronchial anomalies originating from the trachea or main bronchus and directed towards the upper lobe [9]. Displaced segmental bronchi, variants of TB, and bronchial agenesis constitute the minor bronchial anomalies. In this study, we aimed to document the computed tomographic, CT-bronchoscopic and CT-bronchographic appearances of two major bronchial anomalies in three patients. Recognition of these anomalies is important to avoid the possible clinical complications, including recurrent episodes of infection, hemoptysis, and perhaps malignancies.
Case 1
A 58-year-old woman applied to our hospital with a complaint of chronic cough. Physical examination and laboratory results did not reveal any abnormality, nor did the routine chest X-ray. Thorax CT was performed (Sixteen-detector Philips Mx8000 IDT, Netherlands, BV), which revealed a subcarinal area of air density consistent with accessory lung tissue. Neighboring this area was an ACB originating from the medial wall of intermediate bronchus. Coronal reformatted images conWrmed this Wnding and CT-bronchoscopy was performed with postprocessing of raw data retrospectively reconstructed with 1 mm slice thickness and 0.5 mm overlapping. An abnormal oriWce opening into a tubular structure originating from the medial wall of intermediate bronchus was visualized, which was abruptly terminating within 1.5 cm. An additional...